Psychoeducation in Global Mental Health Practice

1. Psychoeducation: Applications for Cross-Systems Practice in International Context Mainstreaming Mental Health in Public Health Paradigms: Global Advances and Challenges Global Foundation for Democracy and Development /Fundación Global Democracia y Desarrollo UN Headquarters, New York Ellen Lukens, PhD, LCSW Columbia University School of Social Work April 11, 2011

2. Psychoeducation • Model that provides collaborative opportunity for participants & facilitators to exchange knowledge & learn together about an area of concern • Evidence-based/evidence-informed • Principle-based/curriculum-driven • Flexible model • Clinical & group practice • Community practice & advocacy • Training

3. PSYCHOEDUCATION • educational & therapeutic interventions work together • therapeutic use of education • knowledge as power • education • psychiatry • Illness & wellness • other life challenges • practical strategies for coping in the face of stress, trauma, & other challenges • community education & collaboration • potential for building community awareness & advocacy skills regarding health & mental health literacy • builds on resilience as well as challenge

4. Why Psychoeducation? • Stress & Trauma Interfere with Processing & Using Information & Knowledge • Can occur at individual, family, community, national level • Understood in different ways depending on culture, history & resources • Haiti • Japan • Kazakhstan • United States

5. Why Psychoeducation-continued? • Stress & Trauma Interfere with Processing & Using Information & Knowledge • Daily life is disrupted & no longer predictable • Can occur at individual, family, community, national level • Can be acute or cumulative or both

6. Intervention or Training Goals • enhance communication • create a common language • foster knowledge exchange • allow participants to bear witness • build self-awareness/pattern recognition • build community & supports • models value of structure, sense of “normalcy”, return to the ordinary

7. Knowledge is power… • and information alone is not enough without… • Insight • Interpretation • Understanding • Context

8. Stages of Healing through Psychoeducation • Safety • Bearing witness • Managing feelings/self-care • Grief & loss • Personal power/self-efficacy • Meaning making • Transformative learning through knowledge exchange • Building community awareness

9. Knowledge as Capital • Integrate information with experience • Knowledge supports safety • Safety supports knowledge • Knowledge leads to self awareness • Self awareness creates opportunity for healing • Knowledge contributes to community advocacy & healing

10. Collaborative Community of Care • Share experience • Learning together • the learning community • the learning collaborative • the learning exchange • Facilitators & members collaborate • Embrace multiple perspectives • Share responsibility & accountability

11. PSYCHOEDUCATION AS COLLABORATIVE MODEL:shifting a paradigm • Participants & facilitators ALL serve as: • educators • students • translators • consultants • facilitators • advocates • monitors

12. Planning a psychoeducational intervention • Assets & needs assessment • Draw on professional & local knowledge to leverage assets & plan intervention • Policy makers • Organizational members & leaders • Community members & leaders • Spiritual leaders • Youth • Curriculum development

13. Sources of Knowledge for Integrated & Cross-Systems Practice in Health & Mental Health • Policy & politics • Organizational knowledge • Research • Practitioner knowledge • User knowledge • Cultural context

14. Assets & Needs Assessment • Professional knowledge (of the expert) • the “experience far” • Local knowledge (of the crowd) • the “experience near”, the lived experience • recognizing • shared history, perspective, world view • Validating both • Privileging neither

15. Challenges to implementation.. • Need for commitment within & across systems • among organizational, community, spiritual, political leaders • (i.e. buy-in from top-down & bottom-up) • Investment in health & mental health literacy among general public • Sensitivity to linguistic & cultural interpretation of stress, trauma, life challenge • Dissemination • Sustainability

16. Potential • Ripple effects of accurate information & knowledge • Bridges formal (provider) & informal (community/family/peer) supports • Reduces power disparities • Can be used as group, community, organizational and/or training model • Can lead to collective & community response & action moving forward • Builds interdependent & mutual support • Builds social capital, agency & community leadership

17. IN SUM... • partnership among professionals & participants • shifting paradigm from challenges to strengths • present focused • focus on critical time periods • attention to timing • active use of group structure • emphasis on education & insight • community building/education • creates a learning collaborative or exchange • parallels principles of community based participatory research